493009022-10-3-2019-01-CC-AHON-BGMR8Z-20191004124844

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493009022
Report Date: 10/03/2019
Date Signed: 10/03/2019 01:21:34 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/01/2019 and conducted by Evaluator Jennifer Velasco

COMPLAINT CONTROL NUMBER: 01-CC-20191001102531

FACILITY NAME:	TREE HOUSE HOLLOW-REDWOOD CAMPUS		FACILITY NUMBER:	493009022
ADMINISTRATOR:	PITTS, JAMIE		FACILITY TYPE:	850
ADDRESS:	565 WATERTROUGH ROAD		TELEPHONE:	(707) 787-8026
CITY:	SEBASTOPOL	STATE: CA	ZIP CODE:	95472
CAPACITY:	15	CENSUS: 10	DATE:	10/03/2019
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Jamie Pitts		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility has a rat infestation.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Velasco conducted an unannounced complaint visit and met with site director (D1). It was alleged that the facility has a rat infestation; specifically, that there has been evidence of rodent infestation throughout the facility for several weeks and that children have thus been exposed to a potential health and safety hazard that has not been effectively remediated. D1 acknowledged the accuracy of the allegation but reported that staff have developed and are implementing a plan to address the infestation. The executive director (M1), three site staff (S2-S4), and two adults (A1-A2) were interviewed on 10/03/2019. LPA attempted to qualify and interview three children but was unable to qualify them as witnesses. During today’s visit the facility was toured, records were reviewed, photographic evidence was obtained, and D1 and three staff were observed providing care and supervision to ten children. Based on the evidence obtained, the preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer Velasco	TELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 2

Control Number 01-CC-20191001102531

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: TREE HOUSE HOLLOW-REDWOOD CAMPUS	FACILITY NUMBER: 493009022
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/04/2019 Section Cited CCR 101238(a)(1)	1 2 3 4 5 6 7	101238- Buildings and Grounds (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	The director (D1) stated the facility will close at 1:00 p.m on 10/03/2019 and will remain closed on 10/04/2019 for professional deep cleaning. Staff will hire pest control professionals to remediate the infestation and will perform deep cleaning to minimize
	8 9 10 11 12 13 14	LPA's observation at 8:00 a.m. on 10/03/19 of the presence of hundreds of rodent droppings in the facility's kitchen (including food prep areas), nap room, classroom, office, and staff bathroom. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14	potential health risks to children, staff, and parents. D1 stated she will train staff to deep clean the facility each day before chidlren are in care and will train staff to ensure children are not exposed to rodent droppings in the facility.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer Velasco	TELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 2